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. 2024 Nov 21;19(11):e0307582.
doi: 10.1371/journal.pone.0307582. eCollection 2024.

A free-living, walking-based, exercise programme, with exercise timed relative to breakfast, to improve metabolic health in people living with overweight and obesity: A feasibility study

Affiliations

A free-living, walking-based, exercise programme, with exercise timed relative to breakfast, to improve metabolic health in people living with overweight and obesity: A feasibility study

Jennifer S Barrett et al. PLoS One. .

Abstract

Optimising the timing of food intake relative to exercise may maximise the effectiveness of free-living exercise programmes on improvements in glycaemic control and cardio-metabolic health. This study aimed to assess the feasibility of a free-living, walking-based exercise programme and determine whether undertaking each exercise session before or after breakfast would most benefit longer-term metabolic health. Thirty-four people living with obesity (43±12 y, BMI 35.1±5.1 kg.m-2) undertook a 12-week walking-based programme, consisting of two continuous (30-60 min at 50% HRmax) and two interval exercise sessions per week (30-60 min, alternating 3 min at 85% HRmax and 3 min at 50% HRmax). Participants were allocated to exercise before (FASTED) or after (FED) breakfast (n = 17 per group). Feasibility (acceptability, adherence and compliance) to the exercise intervention were assessed, as well as changes in anthropometric variables, 24-hour continuous glucose monitoring, serum biochemistry including HbA1c, lipid profile and liver transaminases. Exercise adherence (FASTED: 93±4%, FED: 95±5%) and compliance (FASTED: 85±10%, FED: 88±10%) was high in both groups, and participants described exercise monitoring, programme structure and support as facilitators to this. Body mass, BMI, waist-to-hip ratio and HbA1c decreased similarly between groups (all P<0.01). However, serum ALT concentrations decreased after FASTED (-16± -14%; P = 0.001), but not FED training (-2 ± -4%; P = 0.720). We demonstrate that a free-living walking-based exercise programme, with exercise timed relative to breakfast can achieve high adherence and compliance and improve some anthropometric variables and HbA1c. Whether FASTED exercise can elicit greater improvements in liver health requires further investigation.

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Conflict of interest statement

No author has any conflict of interest, financial or otherwise, with this study.

Figures

Fig 1
Fig 1. Overview of study protocol.
Week 1–2 Individuals inserted the continuous glucose monitoring (isCGM) on day 1 of baseline week for two weeks to include the first week of intervention). During the baseline week, participants carried out a finger prick blood sample, a fitness test (day 5 or 6) and kept a food diary for 3 days. Data from the isCGM was analysed from the 3-days a food diary was kept. Week 12 An isCGM was inserted at start of week 12 of the intervention and this remained in place for two weeks (i.e., week 12 of intervention and follow up week). In follow-up week, participants repeated the finger prick sample, fitness test and reproduced their dietary intake of the 3 days in the baseline week.
Fig 2
Fig 2. Trial flow diagram.
The progress through the phases of a parallel randomised trial of two groups including enrolment, intervention allocation, follow-up, and data analysis.
Fig 3
Fig 3. Area under the curve responses to breakfast, lunch and dinner during the baseline week and follow-up week.
AUC was significantly greater following dinner (*) compared to following breakfast (P >0.05). Data are mean ± SD.

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Grants and funding

This work was supported by Diabetes UK (17/005744). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.